| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | BLUE SHIELD OF CALIFORNIA | $214K | $137 | $214K | 3.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 SOUTH FL 12 ST LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $130K | $0 | $130K | 3.96% |
| USI INSURANCE SERVICES LLC3 Filed as: WELLS FARGO DBA USI INSURANCE SERV | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $27K | $57 | $27K | 3.97% |
| USI INSURANCE SERVICES LLC3 Filed as: WELLS FARGO DBA USI INSURANCE SERV | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $13K | $13K | 1.92% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD., 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $56K | $3K | $58K | 15.62% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $10K | — | $10K | 3.65% |
| USI INSURANCE SERVICES LLC3 Filed as: WELLS FARGO DBA USI INSURANCE SERV | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $5K | $0 | $5K | 3.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO DBA INSURANCE SERV | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $2K | $2K | 1.92% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,042 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,047 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA | 646 | $10.6M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 644 | $797K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,042 | $373K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,042 | $373K |
| Prescription drug(3 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA | 646 | $10.6M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,042 | $645K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,042 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.